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4th Generation HIV Rapid Test done at 14 days after exposure

Question: 

Hi,

I went to a regulated brothel which performs monthly medical checkup on their workers and enforces a usage of condom on 9th July.
I had an oral and vaginal sex with a condom but I kissed the worker and she gave me a handjob after sex but I did not ejaculate in the whole activity. Due to increasing concerns, I did a 4th generation HIV rapid test on 23rd July (exactly 14 days after exposure) and I had a negative result.

May I know the accuracy of the test at that moment?
May I know my risk levels of getting infected?

Regards,
William

Answer: 

Hi there, and thanks a lot for contacting the AIDS Vancouver Helpline for you HIV/AIDS related health information.

It sounds like you are concerned about the reliability of your 4th generation HIV test.

Protected vaginal or anal sex are considered Low Risk activities. This means that they present a potential for HIV transmission because they involve an exchange of body fluids. There have been a few reports of infection attributed to these activities (usually under certain identifiable conditions).

The 4th Generation EIA test is a blood test that looks for antibodies AND P24 protein antigens. P24 is detectable immediately after infections & only for the first few weeks. Its is likely that your test at 14 days would have picked up P24 protein antigens if they had been there. The antibody test has a window period of 4-12 weeks. Most HIV specialists consider this test conclusive at 6 weeks since the accuracy is 99.9%. However, here at AIDS Vancouver we still recommend testing based on World Health Organization guidelines. They state that all HIV tests are considered conclusive at 3 months post exposure. For this reason, I would recommend that you take another test at 3 months post exposure for conclusive test results.

I would encourage you to check out the following resources about HIV:

Thank you for contacting the AIDS Vancouver Helpline.

Hilary

AIDS Vancouver Helpline/Online

helpline.aidsvancouver.org